Volume 92 · Issue 09 · 1979

Radiologic findings of 14 cases of coronary artery fistula (CAF) are presented with emphasis on the diagnostic significance of plain film manifestation. Right coronary artery was involved in 11 cases and left coronary artery in 3 and the fistula drained into right heart-pulmonary artery (RH-PA) system in 10 and into the left ventricle in 4. Hemodynamically, CAF draining into RH-PA system belongs to basal left to right, shunt of the heart, and coronary artery-left ventricle fistula corresponds to that or aortic insufficiency. The "nipple" like protrusion of the right cardiac border and an ovoid opacity superimposed on the anterior cardiac region on lateral film formed by the tortuously dilated coronary artery were found in 4 cases with right coronary artery-left ventricle fistula and one with right coronary artery-right ventricle fistula, are characteristic signs of CAF. Integrating these signs With the simultaneous findings of left to right shunt and aortic insufficiency, the diagnosis of CAF could he suggested. Correlative analysis of radiologic and clinical findings is another important diagnostic clue. The confirmative diagnosis of CAF as well as the demonstration of its anatomical details should rely on contrast studies.

A new contrast echocardiography using hydrogen peroxide is reported, it works on the principle that the catalytic action of the peroxidase of the hydrogen peroxide releases oxygen microbubbles which change the homogeneity of the blood and produce echoes when ultrasound waves are passed through the blood. It is proved experimentally that after intravenous peroxide injection whether satisfactory intracardiac contrast echoes appear on the echocardiogram or not is related to the concentration and amount of the agent injected at 1 time. Concentrations below 1% hardly produce echoes, while concentrations of 3% injected at 1 ml or more a trial produce contrast echoes and the larger the amount injected the stronger the echoes. Untoward reactions are closely related to the dosage. With injection of 1 ml or less of a 3% preparation, there is no ECG change, while injection of 1 ml or more brings T-wave changes and cardiac arrhythmias. If even larger amounts are given the animal may die of ventricular fibrillation. Based on the observations of the correlation between effects and untoward reactions. we deem that a 1.5-3% cancentration at 1-2 ml injected intraveonusly at one time is the appropriate dose for animals of 12-15 kg. These figures are of reference value for clinical work.

Three different kinds of fibers are generated in the course of fracture healing: fibrin fibers, typical collagen fibrils produced by fibroblasts and osteoblasts and equally important atypical collagen fibrils produced by chondroblasts. In the special situation of fracture repair mature collagen fibrils with periodicity can be produced directly in fibroblast cytoplasm.

Of the 50 young children diagnosed clinically as having virus pneumonia, 24 (48%) had type 3 or 7 adenovirus antigen detected in exfoliated nasopharyngeal cells and 2 of them also had the same viral antigen in the lung tissue which yielded type 7 adenovirus. Respiratory syncytial virus antigen was detected in 5 (10%). Type I, II or III parainfluenza virus antigen was detected in 3 (6%) and the same viral antigen was also detected in one of them in the lung tissue which yielded type I parainfluenza virus. Of the 7 infants diagnosed clinically as bronchiolitis, 3 had type 3 or 7 adenovirus antigen detected in exfoliated nasopharyngeal cells and 2 had respiratory syncytial virus antigen. Type I, II or III parainfluenza virus antigen was detected in exfoliated nasopharyngeal cells in 1 child diagnosed clinically as having pleurisy. In 11 children with diseases over than respiratory tract infections, the results of detection of these 3 kinds of viral antigens were all negative. Of the 30 cases of virus pneumonia, a 4-fold or greater rise in hemagglutination-inhibiting antibody titer to types 7 and 3 adenoviruses was demonstrated in 39.5% and 17.9%, totalling 53.8%; a 4-fold or more increase in neutralizing antibody titer to respiratory syncytial virus and a 4-fold or more increase in hemadsorption-inhibiting antibody titer to type I parainfluenza virus were shown in 10.3% each. Of the 5 cases of bronchiolitis, 4-fold or greater rises were shown in antibody titers, 1 case to type 7 adeno- virus, 1 to type 3 adenovirus and 2 to respiratory syncytial virus. No elevation of antibody titers to these 3 kinds of viruses was observed in the 10 children with diseases other than respiratory tract infections. There was goot correspondence between the detection of viral antigens by indirect immunofluorescence and antibody titer assay in paired sera.

The long-term results of 258 cases of intrahepatic portal hypertension treated either surgically (splenorenal shunts) or medically in this hospital during 1953-1975 are analyzed. The 5-year, 10-year, 15-year and 20-year absolute survival rates of the 140 surgical cases and the 118 medical cases were respectively as follows: 67.8% and 21.3%; 52.0% and 7.7%; 50.0% and 2.5% and 30.0% and 0%. The results in the medical group are poorer even if Child's C patients were excluded. Patients treated by splenorenal shunts have a much more favorable prognosis than those treated medically. Prophylactic shunts can considerably reduce the incidence of upper gastrointestinal bleeding and lead to longer survival. Prophylactic shunt is considered a justifiable procedure and spleno-renal shunt the operation of choice.

14 patients with carotid body tumors were treated surgically from 1959 through 1976. The treatment consisted of biopsy 1 case, resection of ectopic carotid body tumor 2 cases, enucleation of tumor 4 cases and tumor excision with an autogenous saphenous vein graft 7 cases. The patient undergoing tumor enucleation with an internal shunt died 28 hours postoperatively, possibly from cerebral thromboembolism. All other patients are living and well, followed up 1-12 years after operation.

The effect of acupuncture analgesia (AA) declined gradually in rats given continuous electroacupuncture for 6-8 hours, giving rise to a state of "acupuncture tolerance". Extracts from the brains of acupuncture-tolerant rats contained a substrate with anti-opiate activity as evidenced by in vitro tests with mouse vas deferens and in vivo tests against morphine analgesia in rats. Intraventricular injection of the substrate also antagonized AA effect in rats.

Thienpydin, an agent with a broad anthelmintic spectrum was used in 2,551 cases of hookworm disease, after its toxicity, parmacology, and potency against the intestinal nematodes had been successfully tried on animals. A single dose at 5 mg/kg yielded a larva negative rate of 88.7% for A. doudenale and 29.8% for N. americanus. Thienpydin was more potent than either tetrachloroethylene alone or tetramisole combined with bephenium. In addition, after thienpydin therapy 136 out of 146 cases were found to be negative for pinworm ova. Side effects were transient and mild.

10 cases of crush syndrome are mainly treated according to the theories, methods and prescriptions of traditional Chinese medicine in accordance with their individual condition. Of them, 7 are mainly treated with Rhizoma rhei 大黄 and Natrii sulfas 芒硝 by purging to remove entero-stagnation Tongli Gongxia 通里攻下 which produces rapid fluid excretion and lowers blood potassium to bring the patients out of danger. Two cases are treated both by this method and peritoneal dialysis. In the other case, Wulingsan 五苓散 (consists of Polyporus umbellatus 猪苓, Poria 茯苓, Rhizoma atractylodis macrocephalae 白术, Rhizoma alismatis 泽泻 and Ramulus cinnamomi 桂枝) is the main treatment. Two patients dIed but the other 8 survived. Purging to remove entero-stagnation alone or combined with promoting blood circulation to remove stasis, Huoxue Huayu 活血化瘀 is effective in treating earthquake victims with crush injuries. It is safer, more reliable, economical and convenient and causes less suffering to the patient than peritoneal dialysis.

This paper presents an elcctrophoretic method in alkaline media, by means of which the change in Hb (increase of HbA, or appearance of HbA3 of diabetic patient is easily detected. Borate buffer (continuous system) is used as electrolyte. Judging by the features of the buffer composition, it is suggested that both normal HbA3 and diabetic "HbA3" may contain a sugar component in the Hb molecule (glycohemoglobin). The distirict heterogeneity of "HbA3" indicates that it probably contains more than one glycohemoglobin. The value of HbA3 in nondiabetic persons ranged from 2.9 to 6.1%. averaging 4.5%, while that of "HbA3" from diabetics ranged from 6.4 to 26.0%, averaging 14.0%. The "HbA3" level was correlated distinctly with the concentration of blood sugar in diabetics. No such correlation was observed between HbA3 and blood sugar in nondiabetic subjects. It is suggested that blood samples from nonfasting patients or patients receiving infusion of liquid containing glucose may be used to analyse "HbA3". Genetic studies on 3 diabetics' families were negative.